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Tubal ligation at the time of cesarean delivery requires significant additional physician work even though the technical work of the procedure is brief. Informed consent by the patient requires considerably more counseling by the physician regarding potential risks and benefits of this procedure t...

Prevention of transmission of the human immunodeficiency virus (HIV) from mother to fetus or newborn (vertical transmission) is a major goal in the care of pregnant women infected with HIV. An important advance in this regard was the demonstration that treatment of the mother with zidovudine (ZDV)...

Competent surgical assistants should be available for all major obstetric and gynecologic operations. In many cases, the complexity of the surgery or the patient's condition will require the assistance of one or more physicians to provide safe, quality care. Often, the complexity of a given surgic...

ABSTRACT: Effective rehabilitation and modern reproductive technology may increase the number of women considering pregnancy who have spinal cord injuries (SCIs). It is important that obstetricians caring for these patients are aware of the specific problems related to SCIs. Autonomic dysreflexia ...

ABSTRACT: Pain management should be provided whenever medically indicated. The American Society of Anesthesiologists (ASA) and the American College of Obstetricians and Gynecologists (ACOG) believe that women requesting epidural analgesia during labor should not be deprived of this service based o...

ABSTRACT: Recent legal actions and policies aimed at protecting the fetus as an entity separate from the woman have challenged the rights of pregnant women to make decisions about medical interventions and have criminalized maternal behavior that is believed to be associated with fetal harm or adv...

ABSTRACT: The Apgar score provides a convenient shorthand for reporting the status of the newborn infant and the response to resuscitation. The Apgar score has been used inappropriately to predict specific neurologic outcome in the term infant. There are no consistent data on the significance of t...

ABSTRACT: Neuraxial analgesia techniques are the most effective and least depressant treatments for labor pain. The American College of Obstetricians and Gynecologists previously recommended that practitioners delay initiating epidural analgesia in nulliparous women until the cervical dilatation r...

ABSTRACT: In light of recent studies that further clarify the long-term risks of vaginal breech delivery, the American College of Obstetricians and Gynecologists recommends that the decision regarding mode of delivery should depend on the experience of the health care provider. Cesarean delivery w...

ABSTRACT: Amnioinfusion has been advocated as a technique to reduce the incidence of meconium aspiration and to improve neonatal outcome. However, a large proportion of women with meconium-stained amniotic fluid have infants who have taken in meconium within the trachea or bronchioles before mecon...

ABSTRACT: Safety concerns have been raised regarding the use of nalbuphine hydrochloride during labor. The American College of Obstetricians and Gynecologists finds data are insufficient to recommend any changes in nalbuphine hydrochloride administration at this time. Opinion
Nalbuphine hydrochlo...

ABSTRACT: In accordance with the new guidelines from the American Academy of Pediatrics and the American Heart Association, all infants with meconium-stained amniotic fluid should no longer routinely receive intrapartum suctioning. If meconium is present and the newborn is depressed, the clinician...

ABSTRACT: Subclinical hypothyroidism is diagnosed in asymptomatic women when the thyroid-stimulating hormone level is elevated and the free thyroxine level is within the reference range. Thyroid hormones, specifically thyroxine, are essential for normal fetal brain development. However, data indic...

ABSTRACT: A joint statement from the American Society of Anesthesiologists and the American College of Obstetricians and Gynecologists was developed to address issues of concern to both specialties. Good obstetric care requires the availability of qualified personnel and equipment to administer ge...

ABSTRACT: There is insufficient evidence to address the safety of any particular fasting period for solids in obstetric patients. Expert opinion supports that patients undergoing either elective cesarean delivery or elective postpartum tubal ligation should undergo a fasting period of 6–8 hours. A...

ABSTRACT: Numerous large clinical studies have evaluated the evidence regarding magnesium sulfate, neuroprotection, and preterm births. The Committee on Obstetric Practice and the Society for Maternal-Fetal Medicine recognize that none of the individual studies found a benefit with regard to their...

ABSTRACT: The work models for the obstetric–gynecologic hospitalist and the obstetric laborist are gaining popularity and momentum in hospitals across the nation. These models could be timely solutions to the challenging demands of the general practice of obstetrics and gynecology. The American Co...

ABSTRACT: Although the Committee on Obstetric Practice believes that hospitals and birthing centers are the safest setting for birth, it respects the right of a woman to make a medically informed decision about delivery. Women inquiring about planned home birth should be informed of its risks and ...

ABSTRACT: In 2010, the Centers for Disease Control and Prevention revised its guidelines for the prevention of perinatal group B streptococcal disease. Although universal screening at 35–37 weeks of gestation and intrapartum antibiotic prophylaxis continue to be the basis of the prevention strateg...

ABSTRACT: Clinicians who provide care for incarcerated women should be aware of the special health care needs of pregnant incarcerated women and the specific issues related to the use of restraints during pregnancy and the postpartum period. The use of restraints on pregnant incarcerated women and...